Development after pediatric brain tumor-a longitudinal study

Background: Patients treated for Pediatric Brain Tumors (PBTs) often experience a decline/stagnation in their cognitive functioning.Anumber of potential risk factors for cognitive decline have been identified including gender (female), young age-at-diagnosis, higher baseline IQ, hydrocephalus at diagnosis, treatment with Whole Brain Radiation Therapy (WBRT), and larger radiation field and/or dose. The aim of this longitudinal study was to statistically model the rate of cognitive decline in a large population-based sample of PBT survivors and to find risk factors for a faster decline. Methods: Study participants were patients diagnosed with PBTs between 2001-2013 and/or who turned 18 years of age between 2006 and 2013 (n = 151). Measures of verbal ability, perceptual reasoning, general cognitive ability, auditory working memory, cognitive processing speed, visual workingmemory and sustained attention were collected longitudinally. Multilevel Linear Modelling (MLM) was used to evaluate the rate of cognitive decline in the sample and to estimate baseline values (risk factors) influencing the rate of decline. Results: A significant decline was found for most cognitive abilities across all patient categories with only elementary verbal skills either stable or improving. Variables predicting lower cognitive performance at baseline were gender (male), age at diagnosis, supratentorial lateral tumor, larger tumor size, and treatment withWBRTor chemotherapy.Conclusions: Pediatric BT survivors experience a decline in age related cognitive performance, regardless of the treatment received. Young age at PBT diagnosis, male, gender, supratentorial lateral tumors, larger tumors and treatment with WBRT or chemotherapy were all correlated with a lowered baseline performance. (Less)